Project Summary/Abstract Low-income Latino children are disproportionately affected by obesity starting in early life. Poor health behaviors contribute to obesity, even from this early age. Unhealthy screen use behaviors are known predictors of short sleep duration, poor diet, and obesity in children ? 3 years old, with growing, yet limited, evidence in children <3. Because low-income Latino children are more likely to have unhealthy screen use behaviors than low-income non-Latino white children, interventions addressing screen use in this population are critical to efforts to reduce obesity disparities. Evidence, including our own, suggests parental television (TV) use behaviors and TV-related parenting practices are predictors of TV use in children ? 3. Today, however, >80% of children use screen devices (e.g. TV, tablet) before age 3. Despite this, little is currently known about the factors contributing to the development of screen use before age 3, or the relationship of such early screen use with sleep, diet, physical activity, and body mass index (BMI). Because screen use behaviors track throughout childhood, intervening on screen use before age 3 may have a lasting impact. By advancing our understanding of how screen use behaviors develop and are related to health outcomes among low- income Latino children <3, we can begin to develop early life interventions to reduce unhealthy screen use in this population. This application?s objective is to identify factors related to early childhood screen use behaviors in low-income Latino children and how those behaviors are, in turn, related to child health outcomes. In this 5- year study, we will recruit low-income Mexican American mothers and fathers with 15 - <27 month olds. Using a mixed methods approach, we will first collect qualitative data from ~40 mothers and fathers to identify parental behaviors and cultural factors related to child screen use in order to adapt/develop measures for this age group (Aim 1). We will then collect quantitative data from 385 families to evaluate associations among parental screen-related behaviors, child screen use, and child sleep duration, diet, physical activity, and BMI (Aim 2) and evaluate the association of sociocultural factors with parental screen-related behaviors (Aim 3). Our central hypothesis, based on family systems theory, is that mothers? and fathers? screen use and screen- related parenting practices shape child screen use, which is associated with shorter sleep duration, poor diet, less physical activity, and greater BMI. Based on the ecological model, we also hypothesize parental screen- related behaviors occur within a sociocultural context. Our long-term goal is to design a clinic-based intervention promoting healthy screen use in low-income Mexican American children < 3 years old. This study will produce novel data on the relationship of parental screen-related behaviors with child screen use and related health outcomes, and the context within which these behaviors occur. In this digital era of highly accessible screens introduced at very early ages, it is imperative that we identify factors associated with early screen use so that we can effectively promote healthy screen use behaviors when they are first developing.